COPD Flashcards
What is the definition of COPD and what is it characterized by?
Define Emphysema
Abnormal and permanent enlargement of the airways distal to the terminal bronchiole.
What are the clinical subtypes of COPD and what are their characteristic features?
What is the difference in diagnosis?
List the top 3 RFs for COPD
What is the normal variant and what are the 2 deficiency variants associated with A1AT deficiency?
What is the most common deficiency genotype?
Normal: M
S&Z are deficiency variants
Homozygous ZZ
What is A1ATD?
What are the most common variants?
What is the main tx of A1ATD and how is it administered?
What is the prevalence of COPD in the general population vs in smokers?
Smoker>general
Where is A1AT produced?
What is its role in the body?
Is the risk of COPD dose-dependent with regards to smoking as a RF?
Yes more smoking, more risk
Explain the pathogenesis of non A1ATD COPD.
Explain the pathogenesis of A1ATD COPD.
What are the symptoms you would like to illicit in a history from a COPD patient?
What is Hoover’s sign?
Lower rib cage moves abnormally inwards on inhalation in COPD patients
What is the typical finding on lung auscultation of a patient with COPD?
Prolonged Expiratory phase
+ Bibasal creps
On auscultation of a COPD patient’s chest, you node a loud P2. What does that indicate?
Based on that information, what would you find on auscultation of the lungs?
any other signs to check?
You then perform an ECG of this patient. What findings are you expecting
Loud P2 indicated pulmonary HTN/Cor Pulmonale => Bibasal crepitations
LL pitting oedema
ECG:
Prolonged/tall P wave (RA enlargement)
RBBB + Right axis deviation (RV hypertrophy)
Describe the exam findings you would expect to find in a COPD patient.
What are some differentials for COPD
- A1ATD
- Ddx of asthma (image)
What are the diagnostic investigations for COPD? What findings would you expect?
What ECG findings are consistent of a patient with severe COPD
Signs of Cor Pulmonale (Tall/prolonged p wave + RBBB + Right axis deviation)
Prolonged QT interval with azithromycin
A fib (Part of DECAF)
What investigations should be performed on a patient started on Azithromycin (include findings)?
In COPD what is the regime?
What is the main organism being targeted?
What is another reason for picking Azithromycin although Tazocin also covers the same organism?
ECG (Prolonged QTc >450/460ms)
Pure Tone Audiometry - Sensorineural hearing loss (all macrolides)
Given 3/week (MWF)
Reasons:
1) P. Auroginosa
2) anti-inflammatory properties
How would you investigate a patient with COPD? Justify each.
How can you tell that the chest is hyperinflated on CXR other than the >6 anterior and >10 posterior ribs at MCL?
Flattened diaphragm
What findings would you expect on CXR in COPD?
What findings would you expect on CT thorax in COPD?
- Air trapping
- Emphysematous bullae
- Bronchial wall thickening
